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Thousands denied cure for blindness due to ban on tissue donation from gay men

FDA declines request by ophthalmologists to revise 1994 policy

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(Photo by Tony Alter; Attribution 2.0 Generic [CC BY 2.0])

WASHINGTON – A first-of-its-kind medical journal study published on Sept. 24 shows that as many as 3,217 intended donations of corneas from the eyes of gay and bisexual men in 2018 that could have restored the vision of blind people through cornea transplant surgery were disqualified under an “outdated” U.S. Food and Drug Administration policy aimed at preventing HIV infection.

The study released by JAMA Ophthalmology, an American Medical Association journal, says the little-known FDA policy prohibits the donation of corneas from men who have had sex with men in the past five years from the time of the planned donation. It points out that the policy has not been revised since the FDA adopted it in 1994 despite major scientific advancements in the detection of HIV in human tissue within eight to 10 days after infection.

“With millions of people across the world in need of corneal transplants, these discarded corneas from gay and bisexual men could be used to address the shortage and safely restore vision to thousands of patients with corneal blindness or visual impairment,” said Dr. Michael A. Puente, assistant professor of ophthalmology at the University of Colorado School of Medicine and lead author of the study.

“With modern virologic testing and a better understanding of the low risk of HIV transmission through corneal transplants, this five-year deferral policy for gay men is not supported by current science,” Puente, an eye surgeon, said in a statement. “We ask federal regulators to reconsider these outdated policies which are depriving patients of the possibility of sight restoration,” he said.

Medical literature on cornea donations and corneal transplant surgery states that similar to heart transplants, corneas can only be donated by people who have died, many of whom have left an advance directive to become an organ or tissue donor.

The statement accompanying the study says all corneal donors in the United States are required to undergo three separate HIV tests. Puente told the Washington Blade the HIV tests can be performed shortly before a terminally ill person dies or shortly after death as long as at least one of the tests is performed within seven days of the time the cornea is donated.

Up until 2015, the FDA adhered to a lifetime ban on men who have sex with men, referred to as MSM, from donating blood. The FDA announced that year that a review it conducted concluded that a lifetime ban was no longer scientifically justified and recommended that MSM considering donating blood be sexually abstinent for one year. In April of this year the FDA lowered the period of abstinence for MSM blood donors to three months.

“If it’s safe for gay men to donate their blood after three months of abstinence, I can think of no scientific reason to continue to require gay men to be abstinent for five years to donate their eyes,” Puente said. “This policy can be changed without increasing the risk of HIV transmission, and I would urge authorities to act as soon as possible to help patients who are waiting for sight-restoring surgery.”

The medical journal article says to the knowledge of the teams of researchers who conducted the study, “no case of HIV transmission from a corneal transplant has been reported anywhere in the world.” The article notes that in cases where a corneal donor was discovered to be HIV positive after a transplant surgery had taken place, none of the recipients contracted HIV.

“One reason for the low transmissibility of HIV via corneal transplant is thought to be the cornea’s avascularity, which prevents the cornea from being a major reservoir of the virus,” according to the article. “Studies analyzing the corneas of HIV-infected patients have consistently found that that HIV is not present in most of the corneas of HIV-positive patients,” it reports.

The statement accompanying the study says the U.S. and Canada are “outliers” in policies restricting corneal donations for MSM. It notes that Canada currently requires MSM to have been abstinent for one year prior to a corneal donation.

“Many countries, including Spain, Italy, Mexico, Chile, and Argentina, allow gay and bisexual men to donate their eye tissue just as easily as heterosexual donors,” the statement says. “Other countries have deferral periods far shorter than five years,” says the statement. “For example, the United Kingdom allows corneal donation by gay and bisexual men after only three months of abstinence, while the Netherlands and France only require gay and bisexual corneal donors to be abstinent for four months.”

Puente told the Blade he learned that members of Congress urged the FDA to modify its MSM cornea donation policy in 2013 and the Eye Bank Association of America in 2017 also called for a change in the policy, but the FDA chose to leave the 1994 policy in place.

Monique Richards, a spokesperson for the FDA, told the Blade in an email in response to a Blade inquiry about the MSM corneal donor policy, that the current policy is based on recommendations by the U.S. Centers for Disease Control and Prevention’s 1994 guidelines published in its journal Morbidity and Mortality Weekly Report.

“Research has shown that a history of male-to-male sexual contact was associated with a 62-fold increased risk for being HIV positive, whereas the increase in risk for a history of multiple sexual partners of the opposite sex was 2.3 fold,” Richards said.

She added that the Centers for Disease Control and Prevention points out that about two-thirds of all new HIV infections in the United states occur in MSM, who make up only 2 percent of the total U.S. population.

“The FDA will continue to review its [tissue] donor deferral policies to ensure they reflect the most up-to-date scientific knowledge,” Richards said. “This process must be data-driven, so the time frame for future changes is not something we can predict.”

The JAMA Ophthalmology article can be accessed here.

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Texas

High School removes LGBTQ ‘Safe Space’ stickers- students walk out

“These aren’t political stickers, they are merely a signal that a teacher has the confidence to have conversations with LGBTQ+ students”

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Photo Credit: GLSEN

IRVING, Tx. — A sizable number of the student body of a suburban Dallas, Texas high school walked out in protest after faculty members were forced to remove LGBTQ “safe space” stickers from their classroom doors.

Dallas ABC News affiliate WFAA ABC 8 reported that hundreds of students walked out of MacArthur High School on Wednesday after students said they began noticing the stickers were being removed from the classroom doors by the administration.

Carrying rainbow flags, the students walked out protesting what they describe as targeted discrimination against the school’s LGBTQ+ students and teachers.

One teacher reported a Safe Space poster she had printed and laminated was missing from outside her classroom too. “I was freaked. The kids were freaked out,” Rachel Stonecipher, an English teacher and sponsor of the campus’ Gay Straight Alliance told CBS-DFW.

Students, she said, immediately wondered who had removed them and what message their disappearance was sending.

“I was a little scared too because I’m the only openly, very obviously gay teacher, lesbian teacher,” said Stonecipher. She and at least four other teachers signed an e-mail to the principal asking for an explanation.

In a statement released to the media, the Irving Independent School District administration said that district policy does not allow teachers to use classrooms to “transmit personal beliefs regarding political or sectarian issues.

“To ensure that all students feel safe regardless of background or identity, the district has developed guidelines to ensure that posters, banners, and stickers placed in classrooms, hallways, or offices are curriculum-driven and neutral in viewpoint,” the statement added.

“These aren’t political stickers, they are merely a signal that a teacher has the confidence to have conversations with LGBTQ+ students,” Stonecipher told reporters.

Irving police were at the school during the walkout as an added presence.

“We have extra resources deployed at MacArthur HS to maintain a safe environment for all,” Irving police tweeted.

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U.S. Federal Courts

Lambda Legal seeks to add two more Trans plaintiffs in West Virginia suit

Federal class-action lawsuit challenging blanket exclusion of health care for Trans people in WVA’s Medicaid & state employee health plan

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Shauntae Anderson and Leanne James (Photo Credit; Lambda Legal)

CHARLESTON, WVa. – Lambda Legal filed a motion seeking leave to add two additional plaintiffs—a Medicaid participant and a public employee—to its federal class-action lawsuit challenging West Virginia’s blanket exclusion of health care coverage for transgender people in West Virginia’s Medicaid and state employee health plans.

If granted, Shauntae Anderson, who is a Medicaid participant, and Leanne James, a public employee and Public Employee Insurance Agency (PEIA) member would be added as additional plaintiffs to Fain v. Crouch.

“My life as a Black transgender woman has not been easy. I suffered years of agony and desperation without appropriate care and treatment for my gender dysphoria. Like other Medicaid participants, I rely on Medicaid for health care coverage and it has been heartbreaking to hear that just because I am transgender, I can’t access coverage for care that is medically necessary. It is not only inhumane but also unjust to be singled out this way,” said plaintiff Shauntae Anderson.  

“It is deeply upsetting that I am deprived of coverage for critical and urgent health care simply because I am transgender. As a public employee and PEIA member, being denied coverage for medically necessary care that cisgender state employees have full access to is an insult to my dignity. The exclusion in the state employee health plans is a reminder to myself and other transgender state employees that we are being denied equal compensation for equal work.” said plaintiff Leanne James.

Filed last November in West Virginia’s Southern District, Fain v. Crouch is a class action lawsuit challenging blanket exclusions of coverage for gender-confirming care in West Virginia state health plans. The blanket exclusions of coverage for care are stated expressly in the health plans offered to Medicaid participants and state employees. West Virginia’s state health plans serve approximately 564,000 Medicaid participants and 15,000 state employees, some of whom are transgender. 

“The state of West Virginia continues to deny medically necessary gender-confirming health care to transgender West Virginians – via explicit and targeted exclusions. West Virginia’s ban on gender-confirming care is unconstitutional and discriminatory; it causes physical, emotional, and financial distress; and it denies transgender West Virginians basic dignity, equality, and respect. Ms. Anderson and Ms. James are just two of many transgender people in West Virginia who are being denied basic health care just because of who they are.” said Avatara Smith-Carrington, Staff Attorney at Lambda Legal and lead attorney on the case.

“We admire Ms. Anderson and Ms. James for stepping forward and joining our original plaintiffs in this lawsuit,” said Nicole Schladt, Associate Attorney at Nichols Kaster, PLLP. “Together, we seek an end to healthcare discrimination in West Virginia.”

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U.S. Federal Courts

Lawsuits against Ohio State over sexual predator sports doctor tossed

“The judge just threw 300 survivors in a trash can,” Steve Snyder-Hill said then adding, “a trash can with an OSU logo on it”

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Screenshot via WBNS-TV, CBS News 10, Columbus, Ohio

COLUMBUS, Oh. – A Federal judge Wednesday dismissed hundreds of pending lawsuits against Ohio State University, (OSU) in cases related to a former OSU sports team doctor Richard Strauss, who had sexually molested young male athletes and other students for twenty years.

In his ruling, U.S. District Judge Michael H. Watson of the Southern District of Ohio wrote;

It is beyond dispute that Plaintiffs, as well as hundreds of other former students, suffered unspeakable sexual abuse by Strauss. It is also true that many Plaintiffs and other students complained of Strauss’s abuse over the years and yet medical doctors, athletic directors, head and assistant coaches, athletic trainers, and program directors failed to protect these victims from Strauss’s predation.”

According to Judge Watson he dismissed the cases because the statute of limitations for criminal rape cases in Ohio is 20 years to report for criminal prosecution or otherwise have legal proceedings initiated.

“If there is a viable path forward for Plaintiffs on their claim against Ohio State, it starts with the legislature rather than the judiciary,” Watson wrote.

Taking aim at Ohio lawmakers Watson noted; ““At all times since the filing of these cases, the Ohio legislature, has the power, but not the will, to change the statute of limitations.” The legislature can provide a “path forward for Plaintiffs on their claim against Ohio State.”

Strauss preyed on hundreds of young men from the time of his employment at OSU in 1978 until he retired in 1998, and allegations about his misconduct didn’t become public until an ex-wrestler named Mike DiSabato spoke out in 2018, years after Strauss’ death by suicide in 2005.

The former athletes were represented by several legal teams including Washington D.C./Oakland, California-based legal advocacy group Public Justice.

Today’s ruling is not only deeply disappointing,” the legal team said in reaction to the ruling today, “but also sends a disturbing message that the very real challenges sexual abuse survivors often face in understanding what has happened to them – and who enabled the abuse they experienced – is irrelevant when they ultimately ask for the court’s help in holding abusive people and institutions accountable.

OSU spent decades denying, hiding, and evading the truth about its role in concealing the abuse that happened on its watch. Today’s ruling punishes survivors already traumatized by the university’s callous campaign of deception. The court’s decision cannot, and must not, be the final word in the survivors’ journey towards justice.”

The case against OSU brought widespread attention as one of the cases involved Strauss victim Steve Snyder-Hill, a prominent LGBTQ activist and a U.S. Army veteran. Upon hearing of Watson’s ruling, a palpably angered Snyder-Hill told several media outlets; “The judge just threw 300 survivors in a trash can,” he said adding, “a trash can with an OSU logo on it.”

Steve Snyder-Hill (Screen shot via WCMH-TV, NBC 4 Columbus, Ohio)

NBC News had reported on the case and profiled Snyder-Hill in 2019:

[…] In the years following the alleged assault, Snyder-Hill would go on to serve in the Iraq War, publicly fight against the military’s “don’t ask, don’t tell” policy and become an outspoken advocate for same-sex marriage. He and his husband, Josh, married in 2011 in Washington, D.C., in front of the tombstone of Leonard Matlovich, a Vietnam War veteran who had been discharged by the Air Force for being gay. The couple were involved in a lawsuit filed by Service Members Legal Defense Network that challenged the federal Defense of Marriage Act (DOMA), which prevented the military from giving benefits to legally married same-sex couples, and successfully fought in court to have their surnames combined in Ohio.

Snyder-Hill was unexpectedly thrust into the media spotlight in 2011 after submitting a question during the Republican presidential debate about whether the candidates would reverse the 2011 repeal of “don’t ask, don’t tell.” Some members of the audience booed Snyder-Hill, who submitted his question by video from his military base in Iraq. That an active-duty soldier in uniform would be booed during a presidential debate shocked and angered many Americans during a time when acceptance for same-sex marriage was mounting. […]

The publicity over the OSU cases also ensnared conservative right-wing Rep. Jim Jordan (R-Ohio), renewing questions over his failure to stop Strauss from molesting former wrestlers Jordan had coached more than two decades ago at OSU. Jordan was accused of that neglect in 2018 by those former wrestlers.

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